The course of frailty and chronic illness will be tracked over 6 years in terms of changes in a set of characteristics that are related to quality of life and potentially to end-of-life attitudes and behavior. The research hypothesizes a cognitive-affective schema, valuation of life (VOL) that is influenced by background factors, health, quality of life, and mental health. VOL is the person's transformations of these inputs and suggested as the major determinant of attitudes and behaviors relevant to the extension versus foreshortening of life. The major hypotheses are that the wish to live is not only decreased by distress but may be incremented by some positive features in the person's daily life. Six hundred elders in good and poor health were recruited for participation in a structured interview, and are beginning the second round of interviews. The present proposal will extend the follow-up period to 6 years, with 270 expected to remain independent, 170 to be ADL-dependent, and 160 to die. Changes over 6 years in Years of Desired Life will be analyzed in terms o changes in health, quality of life, mental health, and VOL. Although multiple comorbidities are the rule, disease-specific trajectories will be sought for 5 illness groups: Congestive heart failure, bowel cancer, diabetes, arthritis, and renal disease among dialysis patients. All analyses will be performed by race (50% African American) and gender. The results will contribute both to clinical practice directed toward the well-being of individuals and to social policy issues where quality of life is involved as a rationale for the distribution of health care costs. A form of religious coping, trusting relationship God, is hypothesized as a moderator of health threat as it influences mental health and VOL.